Risk Factors on Multiple Drug-Resistant Organisms Infection in Patients with Nosocomial Pneumonia and Prognosis Assessment: A National-wide, Multi-center, Large Population, Retrospective Nested Case-control Study

<bold>Background:</bold> Multiple drug resistant organisms (MDROs) in Nosocomial pneumonia (NP) pose cross-transmission, outbreak, and treatment challenges. <bold>Aim:</bold> Analyze NP patients' MDRO infection risk and outcome. <bold>Methods:</bold> Data from 983 NP patients in 12 Chinese hospitals (Jan.2017-Dec.2018) was analyzed. <fig><object-id>erj;64/suppl_68/PA5064/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Results:</bold> MDRO infection 127 cases (12.9%). Significant differences existed in age, comorbidities, hospitalization history, and Glasgow Coma Scale (GCS) between MDRO and non-MDRO infected patients. Factors like repeated hospitalization (OR 5.962) and lower GCS scores (OR 0.935) were MDRO pulmonary infection risks. NP patients with MDRO infection had higher sepsis rates and 30-day mortality risks. <fig><object-id>erj;64/suppl_68/PA5064/F2</object-id><object-id>F2</object-id><object-id>F2</object-id><graphic></graphic></fig> <bold>Conclusion:</bold> MDRO infection impacts NP severity and prognosis. Patients with MDRO infection, especially those with multiple hospitalizations, have increased risks due to individual factors, antimicrobial drug use, and healthcare-associated hand hygiene. Lower GCS scores elevate pulmonary infection risks from environmental or oral bacteria aspiration.